This invention relates to a tool for inserting an intramedullary guide wire.
Over the past twenty years, closed intramedullary rodding of the fractured femur has become a standard procedure. The procedure involves making a hole at the proximal end (top) of the femur, aligned with the femoral medullary canal, the inserting a guide wire through the hole into the canal, and then passing reamers down over the guide wire to enlarge the canal sufficiently that a long metal nail of sufficient diameter to reinforce and maintain alignment and orientation of the bone while it is healing may be inserted substantially the full length of the canal. Several difficult steps of this procedure have been simplified with new techniques and instrumentation, but accurate swift placement of the intramedullary guide wire is still a problem demanding time and tedious dissection.
Inserting a guide wire into the intramedullary canal of the femur would be much simpler if the surgeon could "see" along the axis of the canal. The leg is generally adducted (bent inward at the hip) to improve the situation, but the leg simply cannot be adducted enough so that the canal axis projects clear of the abductor muscle to allow straight insertion of a guide wire. In most cases, an attempt to insert a guide wire into the cancellous bone of the greater trochanter produces a deviated hole, and abrupt contact with the medial cortex, as shown in FIG. 1.